Improve Service Delivery and Efficiency in the Department of Health & Human Services

On February 1, the Health and Human Services Committee held a hearing on LB 1041 and LB 1016. Both of these bills are intended to address problems with the ACCESS Nebraska system.

Appleseed supports both of these bills. LB 1041 would streamline HHS systems to make them more efficient and effective for everyone. LB 1016 would provide resources to community based organizations that assist clients in navigating the current system.

[DDET LB 1041 Testimony]

Chairwoman Campbell and Committee Members
Health and Human Services Committee
Nebraska Legislature

RE: LB 1041 Adopt the Department of Health and Human Services Delivery Improvement and Efficiency Act

Dear Chairwoman and Committee Members:

My name is James Goddard and I am an Associate Director of the Low Income Economic Opportunity Program at the Nebraska Appleseed Center for Law in the Public Interest.  We are a non-profit, non-partisan legal advocacy organization that works for equal justice and full opportunity for all Nebraskans. I am here today to testify in favor of LB 1041.

In the last three years, the Department of Heath and Human Services (HHS) has taken steps to modernize service delivery in public programs, with goals related to efficiency, accuracy and responsiveness.  This overall initiative, called ACCESS Nebraska, completely altered the way client cases are managed and moved towards a focus on use of technology and fewer caseworkers.

Since its creation, we have learned that clients have experienced many problems with the new system[i], including lost documents, long call wait times, and benefit terminations due to reasons other than ineligibility.  Moreover, we are in danger of falling out of compliance with legal timeliness requirements in programs like Medicaid, where a full 8% of all applications are untimely.[ii]

This is why additional steps should be taken to create a service delivery system that is effective and efficient for everyone.  LB 1041 proposes several efficiencies to streamline client case management, making things easier for clients and state workers.

Specifically, LB 1041 would allow the Department to coordinate and streamline eligibility paperwork, which would decrease its workload so that information must be verified less often and fewer mistakes are made. For example, when workers perform renewals for one program they could automatically update and renew for another program.

LB 1041 would also simplify documentation requirements to allow for efficiency while maintaining program integrity. For example, the rules for the Aid to Dependent Children and child care subsidy programs could be aligned with Supplemental Nutrition Assistance Program, by using the least burdensome asset tests.

Finally, LB 1041 would encourage information sharing across programs and governmental agencies to the maximum extent, allowing information to be verified from multiple sources.

In sum, LB 1041 would allow modernization to continue, while ensuring the system is as responsive and responsible as possible.

For all these reasons, we respectfully urge this committee to advance LB 1041.



James A. Goddard
Associate Director-Staff Attorney
Low Income Economic Opportunity Program
Nebraska Appleseed
402 438 8853 x108

[i] Recently the abandonment rate for calls was over 25%, or 1 in 4 persons. See ACCESS Nebraska Legislative Report LB 374 (July-September 2011 Quarter).

[ii]ACCESS Nebraska Legislative Report LB 374 (July-September 2011 Quarter), Application Processing Time Quarterly Reports, Medicaid. Reasons for delays caused by the Department include untimely interviews due to scheduling, not having all verification documents requested, or additional documents being needed. See note 1.

[/DDET] [DDET LB 1016 Testimony]

Nebraska Appleseed is a nonprofit, nonpartisan public interest law firm and advocacy organization working for full opportunity and equal justice for all Nebraskans.

We support LB 1016 because we believe it contributes to creating successful partnerships that serve clients and help health and human services programs work effectively.  LB 1016 aims to ensure that both the Department of Health and Human Services and Community Based Partners (such as Area Agencies on Aging) can effectively play their roles in providing services to Nebraskans.

LB 1016 would strike a balance between the responsibility of the Nebraska Department of Health and Human Services to determine eligibility, provide accurate information, and utilize the skills of community based organizations to connect with clients by establishing contracts with Community Based Partners, which will allow HHS staff to be present at the organizations at specified times.

Community Based Partners offer great strengths to help ACCESS Nebraska succeed, including relationships with clients and knowledgeable and caring staff members. However, nonprofit organizations do not have the capacity to take on additional case management services.  In our work with community based partners, some of the problems that have arisen due to ACCESS Nebraska have included: lack of accurate information, inability to reach caseworkers, poor coordination of services, stress on staff time and organizational resources such as computers, and emergency requests resulting from delay or mishandled benefits.

Providing a “home” for HHS staff members providing such services would allow community based organizations to develop true partnerships between clients, nonprofits, and the Department of Health and Human Services.

We urge you to advance LB 1016.[/DDET]


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